Is post-transplant metabolic syndrome associated with pre-liver transplant visceral adipose tissue area?

Aidan J. Woodward, Matthew P. Wallen, John Ryan, Adrian Hall, Leigh C. Ward, Jeff S. Coombes, Graeme A. Macdonald

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background: Post-liver transplant metabolic syndrome (PTMS) is a significant independent risk factor for the development of cardiovascular disease. The impact of pre-transplant body composition on the risk of developing PTMS has not been evaluated and was the aim of this study. Methods: Seventy-five consecutive adult patients listed for liver transplant were included in the analysis. Anthropometric and metabolic data were collected pre-transplant and at three months post-transplant. Metabolic syndrome was defined in accordance with international guidelines. Skeletal muscle area (SMA), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas were derived from computed tomography. Results: Ten patients (13%) developed de novo PTMS by 3 months post-transplant. Patients who developed PTMS had higher pre-transplant body mass index (BMI) (P = 0.01), VAT (P = 0.001) and SAT (P = 0.008). Univariate logistic regression found that BMI, VAT and SAT were significant predictors for the development of PTMS. After stepwise multivariate analysis, only VAT remained a significant predictor (OR 1.02, 95%CI 1.01–1.04; P = 0.04). Conclusions: Higher pre-transplant VAT is independently associated with the development of metabolic syndrome three months post-transplant. Body composition analysis using cross-sectional imaging prior to liver transplant can assist with identifying patients at greatest risk for developing PTMS.

Original languageEnglish
Pages (from-to)61-66
Number of pages6
JournalClinical Nutrition ESPEN
Publication statusPublished - Oct 2020
Externally publishedYes


  • Liver transplantation
  • Metabolic syndrome
  • Visceral adipose tissue


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